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Contact Information

MARK D FISH, DO
12499 UNIVERSITY AVE
STE. 210
CLIVE, IA50325-8288
 Phone: 515-440-2676
 Fax: 515-440-2677
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Adult Reconstructive Orthopaedic Surgery

207XS0114X 02 Physician/General Surgery
 

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
 

Sports Medicine

207XX0005X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MARK D FISH · (Male)

NPI Number 1548212368
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/17/2006
Last updated 01/23/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 3790
  • IN License # 02003044A
  • IN Other 7305819 AETNA
  • IN Other 000000480577 BCBS
  • IN Other 4178250001 DME
  • IN Other P00325521 RR MEDICARE
  • IN Other 075965 SIHO
  • IN Other 2655165 UNITED HEALTH CARE
Hospital affiliation(s)
  • KNOXVILLE HOSPITAL & CLINICS - (Critical Access)
    1002 SOUTH LINCOLN STREET
    KNOXVILLE, IA 50138
  • MERCY MEDICAL CENTER-DES MOINES - (Acute Care)
    1111 6TH AVE
    DES MOINES, IA 50314
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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